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Objective: The low level of psychiatric research in low- and middle-income (LAMI) countries has been identified as a cause for concern, particularly because the extent of the unmet need for psychiatric treatment in many LAMI countries is not known. The aim of this study was to establish if the worldwide increase in research publication during the last decade included an increase in publication about mental disorders from LAMI countries. Method: We searched PubMed for articles about mental disorder, depression and schizophrenia using the names of LAMI and high-income (HI) countries in the institutional affi liation address (AD) field published during two five-year periods: 1998-2002 and 2003-2007. We then examined the relationship between per capita publications about mental disorder and the independent variables of per capita gross domestic product purchasing power parity (GDP ppp), per capita psychiatric beds, per capita psychiatrists, total population and whether the country had a designated mental health budget. Results: The number of medical research publications per capita, and the number of publications about mental disorder from LAMI countries is low when compared to the rate from HI countries. However, the absolute number of publications from LAMI regions and the proportion of research publications about mental disorder, schizophrenia and depression increased significantly during the decade of the study. There were independent associations between GDP ppp and population size and the rate of publications about mental disorder in LAMI countries. Conclusions: The overall increase in the number of publications about mental disorder in the last decade probably reflects an increase in psychiatric research in LAMI countries. The increase in rates of publication was greatest in middle-income countries with the largest populations.

To authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1467-8519.2009.01773.x Byline: CHRISTIAN MUNTHE (1), SUSANNA RADOVIC (1), HENRIK ANCKARSATER (1) Keywords: dual role dilemma; ethics; forensic psychiatry; informed consent; mentally disordered offenders; public good; research ethics Abstract: ABSTRACT This paper analyses ethical issues in forensic psychiatric research on mentally disordered offenders, especially those detained in the psychiatric treatment system. The idea of a 'dual role' dilemma afflicting forensic psychiatry is more complicated than acknowledged. Our suggestion acknowledges the good of criminal law and crime prevention as a part that should be balanced against familiar research ethical considerations. Research aiming at improvements of criminal justice and treatment is a societal priority, and the total benefit of studies has to be balanced against the risks for research subjects inferred by almost all systematic studies. Direct substantial risks must be balanced by health benefits, and normal informed consent requirements apply. When direct risks are slight, as in register-based epidemiology, lack of consent may be counter-balanced by special measures to protect integrity and the general benefit of better understanding of susceptibility, treatment and prevention. Special requirements on consent procedures in the forensic psychiatric context are suggested, and the issue of the relation between decision competence and legal accountability is found to be in need of further study. The major ethical hazard in forensic psychiatric research connects to the role of researchers as assessors and consultants in a society entertaining strong prejudices against mentally disordered offenders. Author Affiliation: (1)University of Gothenburg Article note: Professor Christian Munthe, Department of Philosophy, Linguistics and Theory of Science, Box 200, 405 30 Gothenburg, Sweden. Email: christian.munthe@phil.gu.se

Objective To set investment priorities in global mental health research and to propose a more rational use of funds in this under-resourced and under-investigated area. Methods Members of the Lancet Mental Health Group systematically listed and scored research investment options on four broad classes of disorders: schizophrenia and other major psychotic disorders, major depressive disorder and other cerumen mental disorders, alcohol abuse and other substance abuse disorders, and the broad class of child and adolescent mental disorders. Using the priority-setting approach of the Child Health and Nutrition Research Initiative, the group listed various research questions and evaluated them using the criteria of answerability, effectiveness, deliverability, equity and potential impact on persisting burden of mental health disorders. Scores were then weighted according to the system of values expressed by a larger group of stakeholders. Findings The research questions that scored highest were related to health policy and systems research, where and how to deliver existing cost-effective interventions in a low-resource context, and epidemiological research on the broad categories of child and adolescent mental disorders or those pertaining to alcohol and drug abuse questions. The questions that scored lowest related to the development of new interventions and new drugs or pharmacological agents, vaccines or other technologies. Conclusion In the context of global mental health and with a time frame of the next 10 years, it would be best to fill critical knowledge gaps by investing in research into health policy and systems, epidemiology and improved delivery of cost-effective interventions. Une traduction en francais de ce resume figure a la fin de l'article. Al final del articulo se facilita una traduccion al espanol. Objectif Fixer des priorites en matiere d'investissement dans la recherche mondiale en sante mentale et proposer un usage plus rationnel des fonds dans ce domaine, qui demeure sous-finance et sous-etudie. Methodes Les Membres du Lancet Mental Health Group ont recense systematiquement et attribue un score aux options d'investissement dans des recherches concernant quatre classes de troubles : schizophrenie et autres troubles psychotiques majeurs, troubles depressifs majeurs et autres troubles mentaux courants, abus d'alcool et autres troubles dus a l'abus de substance et troubles de l'enfant et de l'adolescent (classe large). En appliquant la demarche de fixation des priorites de la Child Health and Nutrition Research Initiative, le Groupe a liste diverses questions a etudier et les a evaluees selon des criteres de resolubilite, d'efficacite, d'aptitude a donner des resultats delivrables, d'equite et d'impact sur la charge persistante de troubles mentaux. Ces scores ont ensuite ete ponderes selon le systeme de valeurs enonce par un groupe plus important de parties concernees. Resultats Les questions a etudier obtenant le score le plus eleve concernaient la recherche sur les politiques et les systemes de sante, les lieux et les modalites de delivrance des interventions d'un bon rapport cout/efficacite dans les pays a faibles ressources, les recherches epidemiologiques sur la categorie large des troubles de l'enfant et de l'adolescent et les questions relatives a l'abus d'alcool et de drogues. Les questions obtenant le score le plus bas concernaient le developpement de nouvelles interventions, de nouveaux medicaments, agents pharmacologiques et vaccins et d'autres technologies. Conclusion Dans le contexte de la sante mentale et a l'horizon des dix prochaines annees, il serait preferable de combler les lacunes les plus criantes en matiere de connaissances en investissant dans la recherche sur les politiques et les systemes de sante, l'epidemiologie et l'amelioration de la delivrance des interventions d'un bon rapport cout/efficacite. Objetivo Establecer las prioridades de inveision en investigaciones mundiales sobre salud mental y proponer un uso mas racional de los fondos en este campo subfinanciado e insuficientemente investigado. Metodos Miembros del Grupo de Salud Mental Lancet procedieron a enumerar y puntuar sistematicamente las opciones de inversion en la investigacion de cuatro amplias categorias de dolencias: esquizofrenia y otros trastornos psicoticos graves, depresion mayor y otros trastornos mentales comunes, abuso de alcohol y otros trastornos por abuso de sustancias, y la gran variedad de trastornos mentales en ninos y adolescentes. Aplicando el criterio de fijacion de prioridades de la Iniciativa de Salud del Nino e Investigacion Nutricional, el grupo confecciono una lista de diversos temas de investigacion y los evaluo conforme a los criterios de justificacion, eficacia, viabilidad, equidad e impacto potencial en la carga persistente de trastornos de salud mental. Las puntuaciones se ponderaron luego de acuerdo con el sistema de valores expresado por un grupo mas amplio de interesados directos. Resultados Los temas de investigacion que obtuvieron una mayor puntuacion guardan relacion con la investigacion de politicas y sistemas de salud, la determinacion de donde y como aplicar intervenciones costoeficaces ya existentes en un contexto de pocos recursos, y la investigacion epidemiologica relacionada con las categorias generales de trastornos mentales de ninos y adolescentes o con aspectos del abuso de alcohol y drogas. Los temas con menor puntuacion fueron los relacionados con el desarrollo de nuevas intervenciones y nuevos medicamentos o agentes farmacologicos, vacunas y otras tecnologias. Conclusion En el contexto de la salud mental mundial y dentro del horizonte de los proximos 10 anos, lo mas conveniente seria llenar algunos vacios de vital importancia en los actuales conocimientos invirtiendo en la investigacion de las politicas y los sistemas de salud, la epidemiologia y la mejora de la aplicacion de intervenciones costoeficaces., Introduction About 14% of the global burden of disease is attributable to mental disorders. (1) Even in sub-Saharan Africa, where communicable diseases are common, mental disorders account for nearly 10% [...]

Health psychology has made limited progress becoming an accepted part of mainstream medical research and practice. Although abundant efficacy research has generated considerable evidence-based interventions that are effective primary medical interventions or adjuncts to other medical treatments, evidence of acceptance within medicine and especially primary care is meager. This special edition of the Journal of Clinical Psychology is an effort to assist movement in this area. It is a combination of commentaries concerning aspects of clinical collaboration within primary care, a discussion of issues that are barriers to implementation, and a wide range of research efforts supporting models of collaborative interventions between health psychology and primary care. It also identifies mechanisms that may account for the effectiveness of certain types of interventions. Taken as a whole the volume supports the importance and viability of clinical health psychology research and practice in an area of fundamental importance--the general health of patients in medical settings--the location where most people present psychological problems and receive treatment in response.

Abstract This paper explores the movement of consumer participation in mental health research, and presents the argument that active consumer participation can produce better and more ethical research. The implications [...]

Primary care patients were surveyed about emotional symptoms, treatment history, and treatment preferences. Four hundred and one patients completed questionnaires while waiting for appointments, and 271 (68%) mailed back additional [...]

Mental health researchers are now expected to include racial and ethnic diversity in their study samples. These studies meet ethics requirements, but the tendency to focus on deontological ethical objectives has not been sufficient to ensure ethical or equitable outcomes for research participants. To ensure these outcomes, we need to emphasize utilitarian ethical principles that take into account the historical and contemporary processes that have promoted negative outcomes for racial and ethnic minority participants in research. Suggestions are made for how both deontological and utilitarian ethical concerns regarding respect, beneficence and justice can be addressed within a broadened research ethic.

The medical model has promoted a train-place model for psychiatric rehabilitation. This model carefully trains people with psychiatric disabilities on a range of skills so they can handle real-world demands before placing them in work and independent living situations. More consistent with a social work perspective are place-train programs, which rapidly place people with psychiatric disorders in real-world settings so they can experience the benefits, as well as the challenges of these situations, and then provide the necessary training and support to successfully maintain these placements. This article compares the two models and shows that place-train approaches can help people with serious mental illness attain many of their work and housing goals without increasing the frequency of relapse. KEY WORDS : psychiatric rehabilitation; serious mental illness; supported employment; supported housing, There are two overarching goals to psychiatric rehabilitation: Help people with disabilities achieve (1) work and (2) independent living goals in the real world. Over the past 30 years, two [...]

The effect of color on the expected and experienced refreshment, intensity, and liking of lemon, mint, and vanilla beverages was studied. Subjects rated the expected and actual taste of brown lemon and mint solutions as less refreshing than the tastes of differently colored solutions of the same flavor. However, the refreshment ratings (expected and actual) of the brown vanilla beverage were not different from those of the vanilla beverages of other colors. Liking ratings also depended on color in a manner similar to that of the refreshment ratings. Intensity ratings also varied with color. However, unlike when subjects smell solutions rather than taste them, colored solutions were not judged as more intense than colorless ones. In fact, the clear solutions were judged as strongest.

The way people with various degrees of musical training integrate timbre, melodic contour, rhythm, and pitch information in an overall pleasantness judgment for musical excerpts was investigated. The theoretical and methodological framework of the study was the functional theory of cognition. In 2 experiments, participants were asked to attribute an overall pleasantness value to combinations of these factors. In Experiment 1, timbre, contour, rhythm, and overall pitch were manipulated. In Experiment 2, timbre and theme (a pattern of pitch and rhythm) were manipulated. Both experiments showed that in judging the pleasantness of musical combinations, participants apply a simple, additive rule in which the weight attributed to one element does not depend of the value of the other elements. Very few differences in regard to the combination rule were observed between participants with and without musical training. These results are discussed in reference to the controversy over pitch and rhythm interaction.

College students were trained on problems similar to the water jar problems developed by Luchins (1942). Some students were instructed that a particular rule would solve all the problems, others had the same problems but were not instructed about the rule, and a third set of students had a series of novel problems in which no single rule operated throughout. In two experiments students in the instructed rule group not only performed best in training but also performed best when transferred to a condition in which a single novel rule was appropriate. Although results from the set of conditions most similar to those of Luchins suggested that students sometimes inappropriately persisted in rule usage, the overall results suggest that rigidity is not a necessary outcome of instructed problem solving. Indeed, many of the results were consistent with the notion that instructed problem solving is flexible problem solving.

In 3 experiments, subjects made comparative judgments on a set of 2 numbers or letters, 3 numbers or letters, or 5 numbers or letters. Numeric and alphabetic serial order memories were contrasted. Three aspects of serial order memory processes were identified: computational complexity, directionality, and accessibility. Computational complexity is the number of algorithmic steps involved in identifying a target. Directional bias is measured as the speed differences in identifying serial targets of equal computational complexity in a stimulus array. Memory accessibility is measured as the numeric and alphabetic serial position effects. Subjects had a slight directional bias favoring backward ordering for single digits but no bias in 2-digit number ordering, in contrast to a strong forward directional advantage in letter ordering. The speed of number access was found to steadily and evenly decrease along the numeric scale, in contrast to a systematic pattern of variations in alphabet access along the alphabetic scale. Finally, the middle item effect (the middle item in a multi-item array is identified most slowly) found in Jou's (1997) multiple-letter comparison study was generalized to numbers.

The purpose of the present study was to investigate the accuracy of the memory for odors and for the location of odors. In Experiment 1, 5 unfamiliar odors were presented in each of 2 rooms. Twenty participants were instructed to remember only the odors (odor-only control group) and 20 were instructed to remember both the odors and the room where the odors were presented (odor place group). In Experiment 2, both the odor presentation room and the sex of the experimenters were manipulated to increase the uniqueness of the odor location. The results demonstrated that the memory for an odor is superior to the memory for the location of an odor. The results also indicated that the intention to learn the sources of an odor improves the memory for the source. These results are discussed in the context of the source monitoring framework.

During a simulated witness interrogation, participants were encouraged to confabulate an account consistent with false information concerning a videotaped event. The interviewer verbally affirmed some false responses. Previous research has shown that, a week later, participants often recognize confabulated events that were affirmed by the experimenter as being from the video. What is unclear is whether confirmatory feedback encouraged a change in the mental representation of the confabulated events to fit the original event or confirmation might have merely encouraged a change in beliefs about the event. To further understand the mechanisms that underlie the confirmatory feedback effect, participants were asked to judge the phenomenological experience associated with false recognition.

This article demonstrates the treatment effectiveness of a mental health Intensive Outpatient Program (IOP) in a private practice setting. Pretreatment and posttreatment symptom and clinician-rated Global Assessment of Functioning (GAF; American Psychiatric Association, 2000) scores were used to determine treatment effectiveness. Reliable change indices and clinically significant change scores were used to control for measurement error and to validate functional change. The IOP patients demonstrated statistically and clinically significant symptom reductions on all 9 clinical scales and 4 global measures of distress, demonstrated movement to less severe levels of functioning, and reported a very high degree of consumer satisfaction. Follow-up data indicated continued improvement and satisfaction. Client satisfaction data and follow-up survey data are also reported.

Current medical, psychiatric, and nursing sources were examined for literature concerning the problem of initial appointment nonattendance at child and family mental health clinics. The factors proposed to underlie missed initial appointments were reviewed and found to be both contradictory and inconsistent. Interventions designed to increase attendance were considered. These interventions were found to significantly increase attendance consistently. However, it is noted that the research on underlying factors is not utilized in structuring these interventions. Suggestions for future research to address this problem are offered.

Perceived causes of suicide attempts were examined in 180 ethnic South Asian women living in the London area. The 3 factors endorsed most frequently and strongly as causes of suicide attempts in South Asian women were violence by the husband, being trapped in an unhappy family situation, and depression.

This study examined an ecological model of maternal substance abuse and child neglect. Data are presented that identified an interplay among family history, interpersonal risk factors, current family functioning, and community networks in examinations of child neglect in a sample of substance-abusing women entering treatment.

A postpartum depression treatment efficacy study showed both a mother-infant psychotherapy group and interpersonal psychotherapy to be superior to a waiting-list comparison group in reducing maternal depressive symptoms, improving mothers' perceptions of their infants' adaptability and reinforcement value, and increasing mothers' positive affect and verbalization with their infants. Clinical implications regarding the importance of early intervention for women experiencing major depression in the postpartum period and their families are discussed.

Using ecological-developmental and resilience perspectives, this study utilizes quantitative and qualitative methods to examine the role of family, community, and individual variables in reestablishing school and work pathways for a diverse sample of 182 Boston-area high school dropouts. Extrafamilial involvement and individual coping style prove the best predictors of on-track status.

The present study is part of larger research aimed at understanding the impact of the family of origin on battered women's lives, worldviews, and emotional setup in the context of dyadic life in violence. The sample constitutes 20 Jewish Israeli battered women. Every woman was interviewed in depth for 3 hr. This was done in 3 sessions. Shame was found to be prevalent in battered women's phenomenological biographies. This cuts across both the family of origin and the subsequent intimate dyadic relationship. Shame traps the battered women, having a pervasive influence on the self, relationships with others, and emotional experiences (shame as emotional abuse), and becomes an obstacle in leaving the violence. Implications for intervention are suggested.

Right-wing authoritarians have been shown to resist change and to demonstrate hostility toward out-groups and social movements that may advocate change from traditional and conventional beliefs. Using data from the Louisville Metropolitan Survey, an omnibus survey of 771 adults interviewed by telephone, the authors investigated the relationship between right-wing authoritarianism (RWA) and attitudes toward mental health services. The findings of the bivariate and regression analyses indicated that high scorers on a version of B. Altemeyer's (1988) RWA index were more likely to hold negative attitudes on mental health services. In particular, the Submissive Authoritarianism scale predicted negative attitudes toward mental health services; however, scores on the Conventionality subscale were not related to attitudes toward mental health services.

The authors hypothesized that a history of adversities, whether they were objectively traumatic or not, predicts risk for 1st onset of PTSD. Survival analysis in a community sample of 1,803 young adults revealed that risk is associated with retrospectively reported adverse experiences that occurred in years prior to the focal traumatic event. Analyses control for clustering of events proximal to onset. Implications for etiology and preventive intervention are noted.

The relationship between stability of living arrangements and adolescent deviance was examined for 212 adolescents in a longitudinal study of maltreated and nonmaltreated children. Transitions in caretakers and residences have a statistically significant relationship to 5 indicators of adolescent deviant behavior. While maltreatment in childhood poses a risk for later deviance in adolescence, the risk can be even greater for those who have experienced more transitions while growing up.

The present study investigated the intergenerational communications between Japanese Americans who were unjustly ordered into U.S. concentration camps during World War II and their offspring born after the war. Survey data were collected from 450 2nd-generation (Nisei) Japanese American former internees to assess patterns of communication with their children about the internment. The study and its results are discussed in relation to racial socialization and the influence of ethnicity on reactions to traumatic stress.

This is the first study to evaluate the efficacy of a structured group therapy for posttraumatic stress disorder (PTSD) in incarcerated male juveniles. Ten groups of juveniles (n = 45) completed a 12-session intervention with pre- and postassessments composed of the Post Traumatic Stress Disorder Reaction Index (C. Frederick, 1985) and supplementary measures of anxiety, anger, and depression. Overall, group participants experienced significant reductions in self-reported PTSD symptoms. Supplemental analyses suggest that this treatment was most beneficial for youth with trauma related to gang and community violence.

The authors explored the social network of caregivers of patients with schizophrenia in relation to relatives' sociodemographic characteristics, patients' clinical variables, family burden, and pessimism about the consequences of the disease. They evaluated 709 key relatives of patients with schizophrenia concerning the above-mentioned variables by means of well-validated questionnaires. A more supportive social network was found in relatives who reported lower levels of burden and pessimism about schizophrenia. The effect of social network on relatives' burden and opinions about schizophrenia was significantly different in relation to relatives' gender. Strengthening the relatives' social network may represent a useful strategy to alleviate their burden and pessimism about schizophrenia.

Aggressive juvenile offenders (mean age = 15.6 years) were classified as persistors (n = 55) or desistors (n = 25) with aggressive crimes 5 years later (mean age = 20.6 years). At adolescence, desistors engaged in fewer aggressive acts, committed fewer property crimes, and behaved less aggressively and more positively toward peers. At emerging adulthood, desistors reported greater emotional support, higher job satisfaction, closer peer relationships, and fewer psychiatric problems. Findings largely remained significant after initial group differences were controlled.

This study focused on the active attempts of individuals with severe mental illness to make sense of their disorders and initiate processes of personal growth. The findings are based on bimonthly comprehensive assessments conducted over a 1-year period with 43 persons who were hospitalized for schizophrenia and related disorders. Results reveal that living with severe mental illness may also generate processes of growth and change. Clinical and theoretical implications of these results are discussed.

Poverty, violence, social inequality, rapid urbanization, the HIV epidemic, and an erosion of traditional values create a challenging environment for development in South Africa. The nation has responded with a range of efforts to promote child welfare, often through efforts to strengthen family functioning. The nation's struggles, failures, and successes at safeguarding the developmental rights of children and providing for their needs offer lessons to others about what can and must be done if they are to live up the obligations assumed as signatories to the United Nations Conventions on the Rights of the Child.

The authors examined caregivers' characteristics and experiences. Previously suggested principles for identifying the primary caregiver in 22 multiple-caregiver families were assessed, but none reliably distinguished the primary caregiver. The authors then compared primary (n = 22), nonprimary (n = 22), and lone caregivers' (n = 43) appraisals of caregiving and psychological distress. Lone and primary caregivers' experiences were similar, but nonprimary caregivers' experiences were less adverse. Despite these findings, greater psychological distress in primary caregivers indicated greater psychological distress in nonprimary caregivers.

Aggression by a random sample of female soldiers (N = 1,185) toward their employed (n = 840) and unemployed (n = 345) civilian husbands was measured by the Conflict Tactics Scale. When age, race, rank, years married, and the number of previous marriages were held constant, severe aggression toward unemployed male spouses was significantly greater than toward employed spouses.

With the current shift to include positive outcomes of trauma, this research was designed to explore factors that allow growth to occur. Structural equation modeling was used to test a model for understanding posttraumatic growth. A sample (N = 174) of bereaved HIV/AIDS caregivers completed questionnaires. Spirituality, social support, and stressors were found to have a positive relationship with growth. Facilitation of posttraumatic growth is crucial to all helping professions.

This follow-up study of 80 Romanian children showed that 16 (20%) of the children exhibited posttraumatic stress disorder (PTSD). The same children got scores in the clinical range on the Child Behavior Checklist (CBCL). These PTSD children could be differentiated from the remaining children by psychosocial but not by physical health variables. Children showing characteristics of PTSD stood out from the other subjects because of their scores on the Externalization dimension and excessive attention-seeking on the CBCL. The findings indicated that these Romanian adoptees exhibited survivor behavior. A substantial number of these adopted children require aftercare by adoption specialists from the time they arrive in Dutch families. It seems plausible that the high incidence of PTSD characteristics was related to extreme physical and social neglect occurring in the orphanages.

This meta-analytic review of prospective and experimental studies reveals that several accepted risk factors for eating pathology have not received empirical support (e.g., sexual abuse) or have received contradictory support (e.g., dieting). There was consistent support for less-accepted risk factors(e.g., thin-ideal internalization) as well as emerging evidence for variables that potentiate and mitigate the effects of risk factors(e.g., social support) and factors that predict eating pathology maintenance(e.g., negative affect). In addition, certain multivariate etiologic and maintenance models received preliminary support. However, the predictive power of individual risk and maintenance factors was limited, suggesting it will be important to search for additional risk and maintenance factors, develop more comprehensive multivariate models, and address methodological limitations that attenuate effects.

In light of the selective focus on maternal (vs. paternal) psychopathology as a risk factor for child development, this meta-analysis examines the relative strength of the association between psychopathology in mothers versus fathers and the presence of internalizing and externalizing disorders in children. Associations were stronger between maternal than paternal psychopathology and the presence of internalizing (but not externalizing) problems in children, with all average effect sizes being small in magnitude. Relations were moderated by variables that highlight theoretically relevant differences between psychopathology in mothers versus fathers (e.g., age of children studied, type of parental psychopathology) and by variables related to methodological differences across studies (e.g., method of assessing psychopathology in parents and children, type of sample recruited, familial composition).

Research indicates that anorexic and bulimic patients who use exercise excessively all exhibit high levels of mental depression, but anorexic patients also showed high levels of somatization and anxiety. Discussion focuses on the possibility that excessive exercise is used by anorexic patients as an affect regulation strategy.